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Tooth Extraction

Tooth Extraction

What Is It?

Tooth extraction is the removal of a tooth from its socket in the bone.

What It’s Used For

If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there’s too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can’t be saved, even with bone replacement surgery (bone graft).

Here are other reasons:

  • Some people have extra teeth that block other teeth from coming in.
  • Sometimes baby teeth don’t fall out in time to allow the permanent teeth to come in.
  • People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
  • People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
  • People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
  • Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
  • Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly come in during the late teens or early 20s. They need to be removed if they are decayed, cause pain or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually taken out at the same time.

If you expect to have treatment with intravenous drugs called bisphosphonates for a medical condition, be sure to see your dentist first. If any teeth need to be extracted, this should be done before your drug treatment begins. Having a tooth extraction after bisphosphonate treatment increases the risk of osteonecrosis (death of bone) in the jaw.

Preparation

Your dentist or oral surgeon will take an X-ray of the area to help plan the best way to remove the tooth. Be sure to provide your full medical and dental history and a list of all medicines you take. This should include both prescription and over-the-counter drugs, vitamins and supplements.

If you are having wisdom teeth removed, you may have a panoramic X-ray. This X-ray takes a picture of all of your teeth at once. It can show several things that help to guide an extraction:

  • The relationship of your wisdom teeth to your other teeth
  • The upper teeth’s relationship to your sinuses
  • The lower teeth’s relationship to a nerve in the jawbone that gives feeling to your lower jaw, lower teeth, lower lip and chin. This nerve is called the inferior alveolar nerve.
  • Any infections, tumors or bone disease that may be present

Some doctors prescribe antibiotics to be taken before and after surgery. This practice varies by the dentist or oral surgeon. Antibiotics are more likely to be given if:

  • You have infection at the time of surgery
  • You have a weakened immune system
  • You will have a long surgery
  • You have specific medical conditions

You may have intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia. If so, your doctor will have give you instructions to follow. You should wear clothing with short sleeves or sleeves that can be rolled up easily. This allows access for an IV line to be placed in a vein. Don’t eat or drink anything for six or eight hours before the procedure.

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